Gut issues are no walk in the park. In fact, they can get in the way of enjoying simple pleasures like a morning stroll, a nice meal, or a social gathering, and in some cases are downright debilitating. Stomach pain; uncomfortable gas, cramps, and bloating; barely reaching the bathroom in time due to diarrhea; or having a hard time passing stool due to constipation are just a few symptoms people navigating gut issues are faced with (1-4). These can feel like tough symptoms to talk about, but it’s important to do so because their influence on quality of life is real (4).
While there are a variety of gut issues ranging in severity, you may find that irritable bowel syndrome, most often referred to as IBS, is one that comes up often in conversation. IBS is a bowel disorder that involves reoccurring episodes of the symptoms previously mentioned (1;4). It’s reported to impact anywhere between 10% to 20% of adults living in Western countries and around 11% of the global population (1;4). Canada has particularly high rates of it, with an estimated 18% of the population affected (1).
Unfortunately, there is currently no cure for IBS. However, treatments that try to help manage symptoms are available. These include medications and lifestyle changes like modifications to exercise habits and diet (4).
For IBS, dietary interventions can include elimination diets (2;3;5). These diets have people temporarily remove specific foods from their diet and then slowly reintroduce them to determine which foods trigger IBS symptoms. Afterwards, a tailored diet that is low in trigger foods is developed (3;5). Low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diets are common elimination diets for IBS (1;2;5). They consist of restricting the consumption of specific carbs found in foods like onion, garlic, rye, corn syrup, grapefruit, beans (and much more), as they aren’t properly absorbed in the bowel (1-3). But do these diets work? Let’s turn to a systematic review for answers (2).
What the research tells us
This review found that low FODMAP diets may improve symptoms in adults diagnosed with IBS in comparison to other diets. These comparator diets included (2):
- following the British Dietetic Association/ National Institute for Health and Care Excellence’s dietary advice, which recommends that people remain adequately hydrated, reduce their consumption of beverages like alcohol, coffee, tea, and carbonated drinks, control fruit consumption, and make sure to eat regularly but keep meals small,
- people continuing with their regular diets,
- receiving sham dietary advice,
- receiving alternative dietary advice, and
- consuming a high FODMAP diet.
These positive results are similar to those found in a previous systematic review from 2018 (3). Unfortunately, just as we saw back then, the quality of the evidence in support of low FODMAP diets for IBS remains very low. This means that as more research is conducted and new studies emerge, the results seen to date may change (2;3).
Despite the uncertainty, for people with IBS, low FODMAP diets are currently an option that their healthcare team may suggest or that they themselves can inquire about. It’s important to remember that due to the restrictive nature of these diets, people should never adopt them on their own. It should be a joint decision between them and their healthcare team so a proper and individualized assessment of benefits and risks can take place and a plan for safely engaging in the diet can be developed.
